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arussell

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About arussell

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Representative Information

  • Name
    Ailene Russell
  • Doctor Representative For
    Dr. Jerry Cooley
  • Location
    United States
  • Years in Hair Transplant Profession
    > 10 Years
  • Email Address
    arussell@haircenter.com

About the Representative

  • Have you Ever Had a Hair Transplant?
    No

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  1. well that being said it is because of the testosterone replacement that this domino effect occurs.... We have never had a side effect from this and have a good many patients use this combination. All meds have a double edge....
  2. To answer your last question, we do not write 1mg finasteride because of all the issues we have had with reliability. If a patients wants 1mg from us they are written brand name.
  3. You are incorrect in your description of the differences in brand vs generic. Fillers are very different generic to generic and the content of the medication is changed by changing this. As I reported, we had no issue allowing people to try this and had huge failure in particular with the one you name among them, these patients went back to brand and stabilized.... So I will disagree with you from practical experience in many many many patients.
  4. Another point, finasteride blocks enzyme #2 at about 65%. Dutasteride blocks 1 and 2 5 aplha reductase enzymes. But it can create a slight spill over of Estrogen in doing this which can cause gynecomastia. If our patients are taking Dutasteride we generally also recommend Arimidex to block that potential. And some docs do recommend taking both ..... at least initially. Because of the 1/2 life of either Dr. Cooley (and many others) do not feel you need to take either on a daily basis.
  5. I will point out that in reading your post you are taking 1 mg fin. Most if not all 1mg fin is made in China or India and is for the most part not reliable. You might want to check your manufacturer. When finasteride went generic, Dr. Cooley like most docs prescribing allowed his patients to use this. In a short time frame we like so many clinics worldwide had so many patients who were shedding and losing ground. The common denominator was the generic Img fin. So, we don't write it and in many instances, if a patient switches to a more reliable brand (we recommend TEVA 5mg) they stabilize. The caveat is that TEVA is a little more expensive and harder to find but don't let a pharmacy tell you they can't get it, not true, they just don't make as much money and don't have a contract with them but any pharmacy can order any medication that is legal. It is all in the hands of their buyer and even varies store to store within the same chain. BUT folks there is a reason co-pays is cheap... so are the ingredients....... and you are not saving if they are not working. In generics they companies use whatever filler they can that costs the least, not works the best and they don't have to tell you what that filler is...... and that is your vehicle of absorption. Just remember all the trials are done on the brand name NOT the generic.
  6. Better is a relative term. They are similar but different. The recommendation to use the stronger is something only you and your physician can determine. As I mentioned it is stronger so in certain situations it works better. We do not generally start out with this, generally, it is something graduated to. Fin blocks at 65%, depending on your genetic programming and your response to medication we start to see that the response is like a bell curve and after a certain time frame, the 30% that is resistant becomes more apparent. Another reason is being on a testosterone replacement which can exacerbate male pattern balding in those susceptible to DHT.
  7. haircrown123 this response is tedious at best. The type of harvesting is not what achieves natural results. Going to a doctor who has artistic talent and great technique is what gives you that result. To imply that with any surgery there is not pain is a disservice. In any surgery you have to have locals administered which is uncomfortable and no one can know any patients threshold for pain. Incisions are made in the recipient area as well as harvesting regardless of the harvesting method. This sounds like pure advertising with less than optimal disclosure......
  8. Etika please read my prior posts. FUE is promoted in a way that is not always full disclosure by some clinics. BOTH harvesting methods "provide excellent and assured results". Both have advantages and disadvantages as I have discussed at length. To say FUE is the only method to provide this is not only incorrect it does patients a disservice in not allowing them to choose what is the best method for them. We do both, and achieve equally good results from either.
  9. Rob, As you said this is your opinion and is in no way based on practical experience or fact. I have pointed out over and over BOTH FUT AND FUE ARE GOOD PROCEDURES IN THE HANDS OF THE RIGHT SURGEON AND TEAM. BUT.... SOME OF YOUR OPINION IS JUST BASICALLY INCORRECT or perhaps you do not understand the basics. You are correct in saying there is only a certain number of grafts that can be harvested regardless of the method. You are incorrect in saying you can harvest equal amounts without consequence. In either method (being redundant here) you have plus and minus to think through. If you have dark hair and very white skin, donor density, skin laxity (for FUT). But if FUE is done and over harvested you are left with diffusely thin donor that nothing can really fix. If an FUT is done and the donor scar is almost undetectable (which is the case in most surgeries using good techniques, a small FUE can be done and is always offered to anyone doing FUT. A stretched scar can occur but is not the standard, it is the exception AND is the reason it is REASONABLE to do FUT first if trying to maximize graft harvesting and to complete with FUE. Dr. Cooley does both methods and does both with success. But either can have limitations. FUT is not the older procedure, FUE is not the newer. FUE is, in FACT, the older, the old plug technique refined. That is not my opinion, it is fact. BUT FUT has also evolved and the old short wide scars or stacked scars are not something that good surgeons now create. Closure technique revolutionized with trico closures in the late 90's early 2000's. No one now uses multi -blades. Suture material has changed, enzymes are used to enhance laxity and much much more. FUE if great for someone who is on medications, does not have extensive loss and family history is not strong for NW 6-7. The patient is well educated on what can occur without meds, pattern of loss and other facts. I worry about some of the very large FUE surgeries done going into the areas of the scalp deemed unstable..... what then, what if the FUE graft is taken from areas susceptable to DUT/ AGA no meds are given or explored, donor is tapped out and loss occurs. I can tell you. In the old days of plugs, no one discussed future loss, hair was moved successfully within native hair and then... 10 years and BOOM... big white round scars. Now, with current FUE the scars would be small BUT THEY ARE STILL JUST AS MUCH A SCAR AS AN FUT SCAR. I repeat both are good procedures in the right scenario. RESEARCH IS THE KEY PEOPLE. Below is a prime example. This patient went somewhere else and had FUE, yes I know where and yes the doc is well known. He came to us with more loss (he was not on meds) and afraid he would have more diffuse thinning with additional FUE. If you look closely you will see Dr. Cooley's FUT scar, which if there was not diffuse thinning would never be visible. With FUE you have to shave the donor, with FUT that is not necessary. BOTH will give you hair where you desire it! But BOTH create scars. With FUE you are able to return to the gym faster because there are no sutures. These are facts, not opinion. I like both and will discuss both factually. Remember this, bad news travels faster than good news. So if someone is unhappy they tell everyone, if they are happy they tell a select few.
  10. FUE has advanced, but so has FUT/FUSS. FUE is the evolution of the old plug transplants, it is not THE advanced technique. It is not always better but can be in some situations, the same is true for strip. It takes a skilled surgeon and team for EITHER procedure. It takes research and disclosure from clinics to potential patients to educate them of the benefits vs the downfall of EITHER. I have been a part of this community and have witnessed the evolution first hand. Facts are facts..... both create scars..... neither cure balding..... both can effectively move hair and in skills hands provide a natural restoration. Neither are perfect. Simrangoyal, I am Clinical Supervisor for Dr. Jerry Cooley. I have also had the honor to be the past chair and the Forum (ISHRS publication former editor for the Assistants Corner). I have been a part of this forum since it's beginning. I am fairly knowledgeable having been in this field for 20 years, about either. Dr. Cooley does not use old techniques. We do both procedures as do many other surgeons; using the latest technology available. Sometimes what is promoted as the latest greatest but in reality is the opposite. Research is key to finding the truth.......
  11. FUE is best for some situations, not all. All of this has been gone over again and again. Both have advantages and disadvantages. FUE does not give perfect more natural results. That is the skill of the surgeon and the clinic. Both can give great results if the patient makes a decision based on fact not on what someone is telling him. Neither are painless that will depend on the individual patient. Nothing is perfect!
  12. "I think the reason is, it gives better results than FUT technique on average. I am not saying it is better because better is a relative term. When we compare all the results of both techniques, FUE seems to be more natural, denser overall. But there are many surgeons who are very successful with FUT type surgeries. But when compared, I believe FUE gives the surgeon more freedom to fill the bald areas. The doctor can pick each follicle according to a schema and the rest is talent. Moreover, I don't know why but usually, when the hair grows, after a certain length, it looks unnatural if it was a FUT. Ordinary people can't see it but if you keep seeing hair, you can tell the difference. I have heard that even the most experienced doctors who have been conducting FUT for decades are now learning FUE technique. I believe the shift will be towards FUE more and more each passing year. Here is my article about FUE and why doctors are switching to it more and more each day, I believe I touched very important points. I do not believe better results are given with FUE and certainly not more density on average. As for hair not looking natural with FUT, if the team is highly skilled then this does not occur. In fact, in our clinic, all FUE grafts are placed under a microscope to ensure they are true 1,2.3 etc and to trim any debris. It is placing that can damage hair and make it look less natural. Incisions have to be carefully made by the surgeon according to the size of the follicle and then placed by skilled placers to avoid crushing or hooking in placement. Both FUE and FUT will give natural results using good technique. As I pointed out above choose carefully what is in your best interest. " Bill the above words are the quote that I was disputing with the last paragraph. I disagree with this statement totally. I do not think results are superior with FUE as I said. Both have advantages and disadvantages. I hate for one to be promoted as the end all of end alls. The fear of the linear scar is from OLD scars or clinics that have not used the newer better methods of closure. BOTH leave scars and the biggest issues I am afraid we will face in the future from FUE is over harvesting, diffuse thinning and just by nature of diffuse thinning fewer available donor grafts to transplant. I have seen quite a few young patients who have done large FUE left with bad moth eaten looks in their donor and not a lot of great options for repair...... Results are pretty similar with the same graft count. But we still dissect under a scope even the FUE so they would all look natural......
  13. I think the reason is, it gives better results than FUT technique on average. I am not saying it is better because better is a relative term. When we compare all the results of both techniques, FUE seems to be more natural, denser overall. But there are many surgeons who are very successful with FUT type surgeries. But when compared, I believe FUE gives the surgeon more freedom to fill the bald areas. The doctor can pick each follicle according to a schema and the rest is talent. Moreover, I don't know why but usually, when the hair grows, after a certain length, it looks unnatural if it was a FUT. Ordinary people can't see it but if you keep seeing hair, you can tell the difference. I have heard that even the most experienced doctors who have been conducting FUT for decades are now learning FUE technique. I believe the shift will be towards FUE more and more each passing year. Here is my article about FUE and why doctors are switching to it more and more each day, I believe I touched very important points. I do not believe better results are given with FUE and certainly not more density on average. As for hair not looking natural with FUT, if the team is highly skilled then this does not occur. In fact, in our clinic, all FUE grafts are placed under a microscope to ensure they are true 1,2.3 etc and to trim any debris. It is placing that can damage hair and make it look less natural. Incisions have to be carefully made by the surgeon according to the size of the follicle and then placed by skilled placers to avoid crushing or hooking in placement. Both FUE and FUT will give natural results using good technique. As I pointed out above choose carefully what is in your best interest.
  14. I am going to repeat what Bill said, "both have advantages and disadvantages". FUE is not "newer", it is refined plugs. Keyword, "REFINED". All things evolve as time elapses and techniques are developed. Old plug scars are not any prettier than old FUT scars. Hair transplants evolved. At first, the focus was to move hair; lots of hair. FUE scars were 6mm sometimes more. But it worked! Linear scars and sometimes stacks of them made the donor not a pretty place..... The focus changed and docs wanted refined scars and if good technique is used this is generally what I see now. FUE is not scarless.... it is just small round scars vs a linear one. The big question with FUE scars seems that the only thing you can do to disguise is micro pigmentation, but for a linear scar you can go in with FUE and very nicely make it almost disappear. With a good doc and clinic either give good results. There are many things that make one better than the other for a specific patient. If a patient is young, not on meds and headed to a NW 5 /6 and above, FUE may not be a good choice. If the skin is very light and the hair very dark FUE scars can make the area motheaten in appearance because of the contrast. If someone wears a short look and goes the gym daily and has less than a NW 4 then FUE might be a better choice. Someone above said everyone has the same amount of follicles available, that is true but not all can always be harvested with good results. You can harvest more with FUT at one time in a first session. Dr. Cooley likes to do combination plans in a lot of patients but education on what each can provide is the real secret. below is a patient who did FUE with another clinic. You can clearly see the motheaten appearance and lack of density in the donor. He needed another session to achieve the density he wanted. At the very bottom of the donor is our FUT scar, almost indiscernible.
  15. We do many things different than the vast majority. Grafts are finely trimmed with no excess tissue at the top, Dr. Cooley controls the depth of all incisions so that the grafts are not buried too deeply. The use of Acell in all surgery and Dr. Cooley's magic post of spay are some of the key components of what we do that is different but the results speak volumes for the reasons behind the extra steps! At the end of the year you will see the full impact of your investment !
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